scholarly journals Changes in the end part of the QRS complex and the ST-T segment in patients with coronavirus infection

2021 ◽  
Vol 40 (1) ◽  
pp. 19-25
Author(s):  
Ekaterina O. Ryadnova ◽  
Viktor P. Kitsyshin ◽  
Vladimir V. Salukhov ◽  
Aleksandr A. Сhugunov
Keyword(s):  
Internal Medicine ◽  
Postgraduate Training ◽  
Mathematical Program ◽  
Underlying Disease ◽  
Irregular Shape ◽  
New Method ◽  
Qrs Complex ◽  
Coronavirus Infection ◽  
The Right

This article is devoted to the patterns of changes in the QRS complex and the ST-T segment in patients with a new coronavirus infection. The article presents the results of a comparison of electrocardiogram data in 70 patients with COVID-19 who were treated in 1st Department of Internal Medicine Postgraduate Training from April to July 2020. Each patient had at least two electrocardiograms taken (at the beginning and at the end of the disease). In the course of the work, a new method for measuring the area of the teeth P, T, QRS complex and ST-T segment was developed and described using the dynamic mathematical program GeoGebra Classic 6.0 by correlating the millimeter grids of the electrocardiogram and the program and further constructing an irregular shape taking into account the polarity of the teeth and segments. According to the study, the sum of the ST-T segment areas in all 12 leads is statistically significantly greater at the end of the disease in individuals over 30 years old. It is also significantly higher in the right thoracic leads (V1-V2) in for all ages. Probably, these changes are associated with the severity of the underlying disease and, consequently, with the overload of the right parts of the heart.

Diplomacy Beyond History: Analytic-Violence, Producer-Centred Research, India

2021 ◽  
pp. 097492842098307
Author(s):  
Deep K. Datta-Ray
Keyword(s):  
New Method ◽  
The West ◽  
History Of ◽  
The Right ◽  
Nuclear Diplomacy ◽  
The Cost ◽  
Insight Into

The history of Indian diplomacy conceptualises diplomacy racially—as invented by the West—and restrictively—to offence. This is ‘analytic-violence’ and it explains the berating of Indians for mimicking diplomacy incorrectly or unthinkingly, and the deleting, dismissing, or denigrating, of diplomatic practices contradicting history’s conception. To relieve history from these offences, a new method is presented, ‘Producer-Centred Research’ (PCR). Initiating with abduction, an insight into a problem—in this case Indian diplomacy’s compromised historicisation—PCR solves it by converting history’s racist rationality into ‘rationalities’. The plurality renders rationality one of many, permitting PCR’s searching for rationalities not as a function of rationality but robust practices explicable in producer’s terms. Doing so is exegesis. It reveals India’s nuclear diplomacy as unique, for being organised by defence, not offence. Moreover, offence’s premise of security as exceeding opponent’s hostility renders it chimerical for such a security is, paradoxically, reliant on expanding arsenals. Additionally, doing so is a response to opponents. This fragments sovereignty and abdicates control for one is dependent on opponent’s choices. Defence, however, does not instigate opponents and so really delivers security by minimising arsenals since offence is eschewed. Doing so is not a response to opponents and so maintains sovereignty and retains control by denying others the right to offense. The cost of defence is courage, for instance, choosing to live in the shadow of nuclear annihilation. Exegesis discloses Balakot as a shift from defence to offence, so to relieve the Bharatiya Janata Party’s (BJP) leadership of having to be courageous. The intensity of the intention to discard courage is apparent in the price the BJP paid. This included equating India with Pakistan, permitting it to escalate the conflict, and so imperiling all humanity in a manner beyond history.

Simulation and Implementation of HLA-Based Branch Predictor of Multi-Pipeline Processor

2012 ◽  
Vol 204-208 ◽  
pp. 4952-4957
Author(s):  
Ji Hua Ye ◽  
Qi Xie ◽  
Yao Hong Xiahou
Keyword(s):  
Simulation System ◽  
New Method ◽  
High Level Architecture ◽  
Hit Rate ◽  
Branch Predictor ◽  
The Right ◽  
High Level ◽  
Two Sides

Researched how the multi-pipeline processor accelerates the running of thread ,found that when the branch predictor facing the random branch instruction, the hit rate will become very low, so bring out a new method that using the free pipeline to accelerate the running of branch instruction. If the right prediction from branch predictor is less than 70% and there is a free pipeline, then using two pipelines to run the two sides of a branch instruction at the same time. In order to test the new method, the HLA (High Level architecture) architecture-based simulation system is established, the results show that the new method can really reduce the time when processing the random branch instructions.

scholarly journals The Application of Bühlmann‑Straub Model with Data Correction for the Estimation of Net Premium Rates in Bonus‑Malus Systems of the Motor Third Liability Insurance

2018 ◽  
Vol 4 (336) ◽  
pp. 7-22
Author(s):  
Anna Edyta Szymańska
Keyword(s):  
Estimation Method ◽  
Third Party ◽  
Liability Insurance ◽  
New Method ◽  
Insurance Companies ◽  
Data Correction ◽  
Insurance Portfolio ◽  
Premium Rates ◽  
The Right

One of the elements used in the process of tariff calculation of premiums in motor liability insurance is a bonus‑malus system. This systems takes into account the “claims ratio” by means of increases and discounts of the base premium called net premium rates. The aim of this work is to propose an estimation method of the net premium rates in the bonus‑malus classes of the motor third‑party liability insurance portfolio of individuals. The Bühlmann‑Straub model was used for the premium estimation. In order to improve the credibility of the estimated premium rates, a data correction in the classes with premium increase was preformed. An example of the application of the new method is presented based on the data obtained from one of the insurance companies operating on the Polish market, which has reserved the right to stay anonymous.

scholarly journals Evaluation of the Mandibular Incisive Canal by Panoramic Radiography and Cone-Beam Computed Tomography

2018 ◽  
pp. 1-13
Author(s):  
Pablo E Tauber ◽  
Virginia Mansilla ◽  
Pedro Brugada ◽  
Sara S Sánchez P ◽  
Stella M Honoré ◽  
...  
Keyword(s):  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Qrs Complex ◽  
Incisive Canal ◽  
St Segment Elevation ◽  
Longitudinal Plane ◽  
St Segment ◽  
Endocardial Mapping ◽  
The Right

Background: Radiofrequency ablation (RFA) in Brugada syndrome (BrS) has been performed both endocardially and epicardially. The substrate in BrS is thus unclear. Objectives: To investigate the functional endocardial substrate and its correlation with clinical, electrophysiological and ECG findings in order to guide an endocardial ablation. Methods: Thirteen patients (38.7±12.3 years old) with spontaneous type 1 ECG BrS pattern, inducible VF with programmed ventricular stimulation (PVS) and syncope without prodromes were enrolled. Before to endocardial mapping the patients underwent flecainide testing with the purpose of measuring the greatest ST-segment elevation for to be correlated with the size and location of substrate in the electro-anatomic map. Patients underwent endocardial bipolar and electro-anatomic mapping with the purpose of identify areas of abnormal electrograms (EGMs) as target for RFA and determine the location and size of the substrate. Results: When the greatest ST-segment elevation was in the 3rd intercostal space (ICS), the substrate was located upper in the longitudinal plane of the right ventricular outflow tract (RVOT) and a greatest ST-segment elevation in 4th ICS correspond with a location of substrate in lower region of longitudinal plane of RVOT. A QRS complex widening on its initial and final part, with prolonged transmural and regional depolarization time of RVOT corresponded to the substrate locateded in the anterior-lateral region of RVOT. A QRS complex widening rightwards and only prolonged transmural depolarization time corresponded with a substrate located in the anterior, anterior-septal or septal region of RVOT. RFA of endocardial substrate suppressed the inducibility and ECG BrS pattern during 34.7±15.5 months. After RFA, flecainide testing confirmed elimination of the ECG BrS pattern. Endocardial biopsy showed a correlation between functional and ultrastructural alterations in two patients.

scholarly journals Knowledge about COVID-19 and Practices among Hemodialysis Technicians in the COVID-19 Pandemic Era

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Amit S. Pasari ◽  
Amol Bhawane ◽  
Manish R. Balwani ◽  
Priyanka Tolani ◽  
Vishal Ramteke ◽  
...  
Keyword(s):  
Infection Control ◽  
Online Survey ◽  
Relevant Information ◽  
Indian Society ◽  
Knowledge Gap ◽  
Institutional Ethics ◽  
Coronavirus Infection ◽  
The Mean ◽  
Knowledge And Attitude ◽  
The Right

Introduction. Hemodialysis technicians play a crucial role in infection control practices in hemodialysis units. Thus, it is important to assess the knowledge and attitude towards COVID-19 among hemodialysis technicians in this pandemic situation. Materials and Methods. An online survey composed of 22 closed-ended questions using Google Forms was conducted in the month of April (13th to 19th) 2020. The survey consisted of questions regarding the knowledge of COVID-19 and current hemodialysis practice among hemodialysis technicians. The study was approved by the institutional ethics board. The survey was administered online through a mobile phone invitation. Basic statistics (mean and standard deviation or total number and percent) were computed for all covariates. Results. Out of 150, 115 technicians participated in the survey. 80.9% of the participants were males. The mean age of respondents was 28.22 + 6.97 years. Most of the respondents could correctly identify fever (87.8%), breathlessness (86.08%), and dry cough (81.7%) as the symptoms of COVID-19 infection. 75.7% of the technicians were aware that it can be transmitted by asymptomatic persons. 61.1% of the technicians were segregating patients who had symptoms such as fever and cough to the last shift of the day. 81.1% of the technicians read the guidelines issued by the Indian Society of Nephrology—COVID-19 working group. But, only 25.5% of the respondents could rightly identify to keep a minimum distance of two meters between two beds while dialyzing a suspected patient of COVID-19 along with other patients to minimise risk of COVID-19 transmission. 60% of the technicians have received hydroxychloroquine as prophylaxis against coronavirus infection. Conclusion. Our study shows a significant knowledge gap among hemodialysis technicians about COVID-19. Effective COVID-19 education campaigns should be carried out intensively with relevant information among hemodialysis technicians to address the knowledge gap. A well-informed hemodialysis technician can prove to be a great tool to spread the right infection control practices among dialysis-dependent patients.

scholarly journals Inter-hospital comparison of working time allocation among internal medicine residents using time-motion observations: an innovative benchmarking tool

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e033021
Author(s):  
Simon Martin Frey ◽  
Marie Méan ◽  
Antoine Garnier ◽  
Julien Castioni ◽  
Nathalie Wenger ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Time Allocation ◽  
Postgraduate Training ◽  
Working Time ◽  
University Hospital ◽  
Direct Patient Care ◽  
Time Motion ◽  
Internal Medicine Residents ◽  
Working Day ◽  
Hospital Comparison

ObjectivesThe vast majority of residents’ working time is spent away from patients. In hospital practice, many factors may influence the resident’s working day structure.Using an innovative method, we aimed to compare working time allocation among internal medicine residents using time-motion observations. The first study goal was to describe how the method could be used for inter-hospital comparison. The secondary goal was to learn about specific differences in the resident’s working day structure in university and non-university hospital settings.DesignTwo separate time-motion studies. Trained peer-observers followed the residents during weekday day shifts with a tablet, able to record 22 different activities and corresponding context (with patient, phone, colleague or computer).SettingInternal medicine residencies at a university (May–July 2015) and a non-university (September–October 2016) community hospital.Participants28 residents (mean age: 29 years, average postgraduate training: 30 months) at university hospital, 21 residents (mean age: 30 years, average postgraduate training: 17 months) at non-university hospital.OutcomesTime spent with patients and time dedicated to activities directly related to patients; description of main differences of time allocation between hospitals.ResultsCumulatively 1051 hours of observation (566 (university hospital)+486 (non-university hospital)) and 92 day shifts (49+43) were evaluated. Daily working time was 11.5 versus 11.3 hours. A median daily period of 195 min (IQR 179–211, 27.9%) and 116 min (IQR 98–134, 17.2%) (p<0.001) was dedicated to direct patient care, respectively.ConclusionsWe successfully identified differences potentially related to each hospital structure and organisation. Inter-hospital comparisons could help set up interventions aiming to improve workday structure and experience of residents.

Organinteraktionen: Herz und Lunge – Management des akuten Rechtsherzversagens

2017 ◽  
Vol 142 (18) ◽  
pp. 1357-1364 ◽  
Author(s):  
Guido Michels ◽  
Roman Pfister
Keyword(s):  
Heart Failure ◽  
Therapy Monitoring ◽  
Right Heart Failure ◽  
Underlying Disease ◽  
Individual Therapy ◽  
Treatment Goals ◽  
Right Heart ◽  
Non Invasive ◽  
The Right ◽  
Focused Echocardiography

AbstractThe pathophysiology and the management of patients with acute right heart failure are very complex. The bed-side focused echocardiography is the basis of differential diagnosis and acute diagnosis. Individual therapy monitoring is complex due to the strong preload dependence of the right ventricle and the limitation of non-invasive estimation of pulmonary-vascular hemodynamics, so that the indication for a pulmonary artery catheter should be liberal in acute right heart failure. The treatment goals of acute right heart failure are the treatment of the underlying disease or triggering factors in combination with individualized optimization of hemodynamic tailored to current right-ventricular function.

Ventricular activation process and genesis of QRS complex in the goat

1961 ◽  
Vol 200 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Robert L. Hamlin ◽  
Allen M. Scher
Keyword(s):  
Interventricular Septum ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Activation Process ◽  
Qrs Complex ◽  
Complex Activity ◽  
Single Burst ◽  
Ventricular Activation ◽  
The Right ◽  
Apical Area

The pathways of ventricular excitation in the interventricular septum and the free walls of the ventricles were determined in the goat. During the first 5 msec. of the QRS complex, activity occurs in a cup-shaped zone formed around the apex of the left ventricular cavity, consisting of the left endocardial portions of the septum and the endocardium of the free wall. Within the next 10 msec. of the QRS, the apical third of the septum is excited, simultaneously, from both the left and the right ventricular endocardial surfaces. Also, all of the ventricles, except the bases and a small epicardial apical area of the left ventricle, are excited with almost a single burst of depolarization. During the next 3–5 msec. the ventricular bases and the small apical epicardial area are excited along with the middle third of the interventricular septum. The final 15 msec. of the QRS and approximately 3 msec. of the following isoelectric period are inscribed during activation of the basilar third of the septum.

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